HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
ISC
FILLED LAND AFFIDAVIT S 9ti
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I, the undersigned, am the owner of the following described property,
Id#/Legal
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number t acknowledge
that as owner of the above described property, an in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither 'obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Proper Owner Name (Please Print)
` 1 -- - A
Property Owner Signature Date
STATE OF FLORIDA, COUNTYOF CC
ACKNOWLEDGED BEFORRE�11�4.,(E_TEERS✓ �1 _ DAY OF �� C .20�,
BY-J � e&P—A--r'ft✓ WHO IS PERSONALLY KNOWN TO ME (ElOR WHO HAS
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
g4rrr, KAREN S. IJIELState of Florida -Notary pu Publ c
•_= Commission 0 GG 207484
My Commission Expires
SLCPDSD Revised 04/1 V2011
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